THE Ministry of Health's (MOH) recent move to ban alternative tobacco products is certainly welcome ("Alternative tobacco products to be banned"; Tuesday).

Cigarettes are the only consumer products that kill half their users when used as directed by their producers.

As a country, we should, therefore, be aggressive in reducing the number of cigarette smokers.

Similarly, we should be aware of the increasingly wide variety of non-cigarette forms of tobacco and nicotine, including bidis, kreteks, narghile (water pipes), snus (Swedish moist snuff), as well as other forms of oral tobacco.

These alternatives are not only harmful in themselves but may also be initiators to cigarette smoking.

Recent data has shown that 20 per cent of Swedish men who used snus went on to pick up smoking.

While these forms of tobacco are often touted as safer alternatives to cigarette smoking, studies show otherwise.

In fact, according to experts from the International Agency for Research on Cancer, smokeless tobacco products can contain up to 30 cancer-causing agents.

Studies in India, Pakistan and Sudan describe large increases in the risk of oral cancers related to the use of different smokeless products.

Individuals who use alternative tobacco products like electronic cigarettes, oral tobacco, narghile, cigars, and snus all report varying degrees of health consequences.

For instance, emissions from e-cigarettes contain ultra-fine particles which travel deep into the lungs and cause tissue inflammation. The mist contains at least 10 chemicals known to cause either cancer, birth defects and/or other reproductive harm.

Why is the use of alternative tobacco products so prevalent despite the documented adverse effects?

First, scientific knowledge about alternative tobacco forms remains scarce and limited, making it difficult to regulate users' access to these products.

Creative advertising tactics by manufacturers tend to over-sell the purported, albeit unsubstantiated, health benefits.

Consumers, especially young adult users, are generally confused or lack the understanding of the health risks of these products.

We must remain vigilant against the related health risks, which are comparable to, if not greater than, those resulting from use of conventional cigarettes.

There is an urgent need to better understand innovation trends within the tobacco industry to put in place more effective strategies to regulate promotion and marketing, and, more crucially, to control the use of such alternative tobacco products.

Chia Kee Seng (Professor)